Organization
NORTHWOOD DEACONESS HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PETE ANTONSON CEO (ADMINISTRATOR)
(701) 587-6060
Entity
Organization
Contact information
Practice address
4 NORTH PARK STREET, NORTHWOOD, ND 58267-0190
(701) 587-6060
(701) 587-6492
Mailing address
PO BOX 190, NORTHWOOD, ND 58267-0190
(701) 587-6060
(701) 587-6492
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1045A
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001503
BCBS
ND
05
—
30031
—
ND
Enumeration date
09/20/2006
Last updated
11/01/2011
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